THE POWER OF THE DECISION
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at the start of my career , Navy medicine was my all-time largest “ group-practice ” setting , with , obviously , the United States of America as my most prodigious employer .
My medical journey has taken me past several roads diverged . First , I had to decide if I even wanted to be a doctor ( full disclosure , after coming off active duty in the Navy , I picked up an application for the LSAT at the UofL Law School ). I also had to decide what type of medicine I would practice – a process that , likely , will never be fully completed . I did my internship in psychiatry ; my residency in anesthesiology ; my fellowship in pain medicine ; and most recently , I ’ ve become board-certified in addiction medicine . Somewhere along the way , I even got a master ’ s degree in medical management , in part because I want to possess business acumen / credentials in the unlikely event I ever decide to seek employment as a health care administrator . One of the really beautiful aspects of a career as a physician is
that I can always evolve , can always resist being professionally pigeon-holed , and can always contribute in some meaningful measure as a caregiver , should I choose , until my days are done . I ’ m honored , humbled and grateful to be a physician .
My professional life has been most fulfilling when I have not been swimming against the current – in other words , when I have been following a path in accord with my values , abilities , and , yes , dreams ( on my medical school application I described myself as a “ dreamer with a flair for the practical ” - this is still true ). Like any physician , understanding the path my professional journey has taken is similar to understanding “ standard of care ,” i . e ., it ’ s not a universal truth , but rather is dependent upon : ( a ) the individual person , ( b ) the place and ( c ) the time . With this in mind , it stands to reason that one ’ s decision whether to work as an organizationally-employed physician vs . a self-employed physician should come after a critical self-inventory .
With respect to private practice , “ person ” questions need to
Features of Different Practice Models
( From the AMA Private Practice Playbook , downloaded , 12 / 7 / 2023 . www . ama-assn . org / system / files / steps-forward-private-practice-playbook . pdf )
10 LOUISVILLE MEDICINE